MEDICARE: BLUE OASIS HOME CARE AGENCY , LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	374U00000X	Home Health Aide
3	251E00000X	Home Health Agency
4	175T00000X	Peer Specialist
5	103K00000X	Behavior Analyst
6	171400000X	Health & Wellness Coach
7	247000000X	Health Information Technician
8	372600000X	Adult Companion
9	343900000X	Non-emergency Medical Transport (VAN)
10	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1861116170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUE OASIS HOME CARE AGENCY , LLC

Provider Business Mailing Address
First Line	:	711 BRODERICK CIR
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-2415
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	711 BRODERICK CIR
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-2415
Country	:	US
Telephone Number	:	762-821-5618
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	CHARONDA DENIECE SMITH
Credential	:
Telephone Number	:	762-821-5618

Provider Enumeration Date	:	09/29/2022
Last Update Date	:	05/29/2026

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